Volume 3, Issue 3, September 2019, Page: 45-51
HAART Use and Cardiovascular Risk Among HIV Patients in Rivers State, Nigeria
Ajala Aisha Oluwabunmi, Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Choba, Rivers State, Nigeria
Ofori Sandra Nnedinma, Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Choba, Rivers State, Nigeria
Odia Osarentin James, Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Choba, Rivers State, Nigeria
Received: Jun. 26, 2019;       Accepted: Jul. 24, 2019;       Published: Aug. 7, 2019
DOI: 10.11648/j.ccr.20190303.11      View  22      Downloads  5
Abstract
Cardiovascular diseases have been associated with deaths among HIV seropositive persons in low income countries. This was a cross-sectional study of cardiovascular risk among 100 HIV seropositive persons and 100 age and sex matched seropositive but HAART-naive controls in Rivers state, Nigeria. The study subjects underwent clinical examinations to determine their blood pressure and anthropometric parameters. Blood samples were taken to assess fasting blood glucose and lipid profile. Risk assessment was done using the WHO/ISH cardiovascular risk score chart. Among the subjects, 76 (76%) were on a non-PI based HAART compared with 24 (24%) on a PI-based HAART. The mean BMI and CD4 count were significantly higher among the cases than the controls (p =.0.048 and p < 0.0001 respectively). There was a statistically significant difference in the mean SBP (131.90 ± 14.33mmHg versus 127.48 ± 12.03mmHg) and DBP (83.88 ± 6.59mmHg versus 80.63 ± 6.74mmHg) between the cases and controls (p = 0.019 and 0.023 respectively). Dyslipidaemia was higher among the cases than the controls (low HDL-c was 36% vs 33%; increased TC 20% vs 7%; increased LDL-c 13% vs 4% and triglycerides 7% vs 5%. The prevalence of hypercholesterolemia and increased LDL-c was significantly higher among the cases than the controls (p = 0.007 and 0.022 respectively). The prevalence of intermediate to high CV risk score was higher among the HAART experienced HIV seropositive subjects compared to control subjects.
Keywords
Cardiovascular Risk, HAART, HIV
To cite this article
Ajala Aisha Oluwabunmi, Ofori Sandra Nnedinma, Odia Osarentin James, HAART Use and Cardiovascular Risk Among HIV Patients in Rivers State, Nigeria, Cardiology and Cardiovascular Research. Vol. 3, No. 3, 2019, pp. 45-51. doi: 10.11648/j.ccr.20190303.11
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Mendis S, Puska P, Norrving B. Global Atlas on Cardiovascular Disease Prevention and Control, WHO in collaboration with the World Heart Federation and the World Stroke Organization. 2011; 3-18. ISBN 978-92-4-156437-3.
[2]
Global 2013 Mortality and all cause of death collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015; 385 (9963): 117-171.
[3]
World Health Organization. Cardiovascular diseases fact sheet, updated May 2017. Available at: http://www.who.int/mediacentre/factsheets/fs317/en/. Assessed May 2017.
[4]
Beaglehole R, Bonita R. Global public health: A scorecard. Lancet. 2008; 372 (9654): 1988-1996.
[5]
Mensah GA, Roth GA, Sampson UK, Moran AE, Feigin VL, Forouzanfar MH et al. Mortality from cardiovascular diseases in sub-Saharan Africa, 1990–2013: a systematic analysis of data from the Global Burden of Disease Study 2013. Cardiovasc J Afr. 2015; 26: S6-S10.
[6]
Yusuf S, Reddy S, Ôunpuu S, Anand S. Global burden of cardiovascular diseases. Part I: General considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001; 104 (22): 2746-2753.
[7]
Reinsch N, Neuhaus K, Esser S, Potthoff A, Hower M, Mostardt S et al. Cardiovascular risk factors in HIV: results of the HIV-HEART study. European Journal of Preventive Cardiology. 2012; 19 (2) 267-274.
[8]
Neuhaus J, Angus B, Kowalska JD, La Rosa A, Sampson J, Wentworth D et al. INSIGHT SMART and ESPRIT study groups. Risk of all-cause mortality associated with nonfatal AIDS and serious non-AIDS events among adults infected with HIV/AIDS. AIDS 2010; 24 (5): 697-706.
[9]
Antiretroviral Therapy Cohort Collaboration, causes of death in HIV-1-infected patients treated with antiretroviral therapy, 1996-2006: collaborative analysis of 13 HIV cohort studies. Clinical Infectious Diseases. 2010; 50 (10): 1387 – 1396.
[10]
White AJ. Mitochondrial toxicity and HIV therapy. Sex Transm Infect. 2001; 77 (3): 158-173.
[11]
Dube MP, Stein JH, Aberg JA, Fichtenbaum CJ, Gerber JG, Tashima KT et al. Guidelines for the evaluation and management of dyslipidemia in human immunodeficiency virus (HIV)-infected adults receiving antiretroviral therapy: recommendations of the HIV Medical Association of the Infectious Disease Society of America and the Adult AIDS Clinical Trials Group. Clin Infect Dis. 2003; 1 (37 (5): 613-627.
[12]
Reyskens PM, Essop MF. HIV protease inhibitors and onset of cardiovascular diseases: a central role for oxidative stress and dysregulation of the ubiquitin-proteasome system. Biochims Biophys Acta 2014; 1842 (2): 256-268.
[13]
Mendis S, Lindholm LH, Mancia G, Whitworth J, Alderman M, Lim S et al. World Health Organization and International Society of Hypertension risk prediction charts: Assessment of cardiovascular risk for prevention and control of cardiovascular disease in low and middle-income countries. Journal of Hypertension. 2007; 25: 1578-1582.
[14]
Martin S, Blaha M, Elshazly M. Brinton E, Toth P, McEvoy J et al. Friedewald-estimated versus directly measured low-density lipoprotein cholesterol and treatment implications Journal of the American College of Cardiology. 2013; 62 (8): 732-739.
[15]
Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel ІІІ) final report. Circulation. 2002; 106 (25): 3143-3421.
[16]
World Health Organization, Global HIV/AIDS Statistics November 2014. Available at: https://www.aids.gov/hiv-aids-basics/hiv-aids-101/global-statistics. Assessed on June 2017.
[17]
Rathbun CR, Liedtke MD, Staci ML. Antiretroviral Therapy in HIV infection. Medscape. Available at: http://emedicine.medscape.com/article/1533218. Accessed on January, 2019.
[18]
Nsagha DS, Assob JC, Njunda LA, Tanue EA, Kibu DO, Ayima WC et al. Risk factors of cardiovascular diseases in HIV/AIDS patients on HAART. AIDS. 2015; 9: 51–59.
[19]
Mashinya F, Alberts M, Colebunders R. Assessment of cardiovascular risk factors in people with HIV infection treated with ART in rural South Africa: a cross sectional study. AIDS Research and Therapy. 2015; 12 (1): 42-52.
[20]
Feeney RE, Mallon PW. HIV and HAART – Associated Dyslipidema. The Open Cardiovascular Medicine Journal. 2011; 5: 49-63.
[21]
Muhammad S, Sani MU, Okeahialam BN. Cardiovascular disease risk factors among HIV-infected Nigerians receiving Highly Active Antiretroviral Therapy. Nigerian Medical Journal. 2013; 54 (3): 185-190.
[22]
Danwe C, Atchou G, Nkam M, Mbuagbaw J, Mougnoutou R, Nkouanfack C et al. Effect of Antiretroviral Therapy on Lipid Metabolism in HIV/AIDS Subjects in Cameroon. Journal of Medical Sciences. 2005; 5 (2): 78-82.
[23]
Riddler SA, Smit E, Cole SR, Li R, Chmiel JS, Dobs A et al. Impact of HIV infection and HAART on serum lipids in men. JAMA. 2003; 289 (22): 2978-2982.
[24]
Nery MW, Martelli TM, Silveira EA, Oliveira Falco M, Oliveira de Castro CA, Esper JT et al. Cardiovascular Risk Assessment: A Comparison of the Framingham, PROCAM, and DAD Equations in HIV-Infected Persons,” The Scientific World Journal. 2013: Article ID 969281.
[25]
Friis-Møller N, Sabin CA, Weber R, D'Arminio Monforte A, El-Sadr WM, Reiss P et al. Combination antiretroviral therapy and the risk of myocardial infarction. Data Collection on Adverse Events of Anti-HIV Drugs (DAD) Study Group. N Engl J Med. 2003; 349 (21): 93-103.
[26]
Dube MP, Stein JH, Aberg JA, Fichtenbaum CJ, Gerber JG, Tashima KT et al. Guidelines for the evaluation and management of dyslipidemia in human immunodeficiency virus (HIV)-infected adults receiving antiretroviral therapy: recommendations of the HIV Medical Association of the Infectious Disease Society of America and the Adult AIDS Clinical Trials Group. Clin Infect Dis. 2003; 1 (37 (5)): 613-627.
[27]
Obirikorang C, Quaye L, Osei-Yeboah J, Odame EA, Asare I. Prevalence of metabolic syndrome among HIV-infected patients in Ghana: A cross-sectional study. Niger Med J. 2016; 57 (2): 86–90.
[28]
Ghorpade AG, Shrivastava SR, Kar SS, Sarkar S, Majgi SM, Roy G. Estimation of the cardiovascular risk using World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction charts in a rural population of South India. Int J Health Policy Manag. 2015; 4 (8): 531–536.
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